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皮下转移灶揭示的肺黏液腺癌:罕见表现的病例报告

Invasive mucinous adenocarcinoma of the lung revealed by a subcutaneous metastasis: A case report of a rare presentation.

作者信息

Hasnaoui Anis, Trigui Racem, Benasr Amal, Nouira Mariem, Ben Abdallah Fakhreddine

机构信息

Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar 1006, Tunis, Tunisia; Department of General Surgery, Menzel Bourguiba hospital, Tunisia.

Faculty of Medicine of Tunis, Tunis El Manar University, Rue Djebal Lakhdar 1006, Tunis, Tunisia; Department of General Surgery, Menzel Bourguiba hospital, Tunisia.

出版信息

Int J Surg Case Rep. 2023 Nov;112:108964. doi: 10.1016/j.ijscr.2023.108964. Epub 2023 Oct 17.

Abstract

INTRODUCTION

Lung cancer stands as the second most prevalent tumour and the foremost cause of cancer-related mortality. It typically manifests through respiratory symptoms. Subcutaneous metastases originating from pulmonary cancers are rare occurrences, with a remarkably low incidence.

PRESENTATION OF CASE

A 53-year-old patient, with a history of smoking and unchecked chronic obstructive pulmonary disease, sought care at our outpatient clinic due to the rapid development of a subcutaneous mass. The patient underwent surgical excision of the mass under local anaesthesia. The anatomopathological examination confirmed the diagnosis of cutaneous metastasis from an infiltrative adenocarcinoma. A whole-body CT scan revealed an invasive mucinous adenocarcinoma of the lung. Consequently, palliative chemotherapy was initiated. Unfortunately, the patient succumbed to the disease three months later.

DISCUSSION

Subcutaneous metastasis originating from pulmonary sources is a rare phenomenon, with scant literature available on the subject. The presence of pulmonary cutaneous metastasis serves as an ominous sign of rapidly progressing and aggressive lung cancer. The prognosis in such cases is reserved, with an overall survival rate measured in months. The approach to management in these instances predominantly revolves around palliative chemotherapy, although surgical excision of metastases may be considered in select cases.

CONCLUSION

Lung cancer unmasked by subcutaneous metastasis represents a rare clinical scenario. While chemotherapy remains the cornerstone of treatment, surgical intervention to remove metastases may be contemplated in a restricted subset of cases. Further research is imperative to ascertain the impact of surgery on both quality of life and overall survival.

摘要

引言

肺癌是第二大常见肿瘤,也是癌症相关死亡的首要原因。它通常通过呼吸道症状表现出来。源自肺癌的皮下转移很少见,发病率极低。

病例介绍

一名53岁患者,有吸烟史且慢性阻塞性肺疾病未得到控制,因皮下肿块迅速增大到我院门诊就诊。患者在局部麻醉下接受了肿块的手术切除。解剖病理学检查确诊为浸润性腺癌的皮肤转移。全身CT扫描显示为肺部浸润性黏液腺癌。因此,开始了姑息化疗。不幸的是,患者三个月后死于该疾病。

讨论

源自肺部的皮下转移是一种罕见现象,关于该主题的文献很少。肺部皮肤转移的存在是快速进展和侵袭性肺癌的不祥征兆。此类病例的预后不佳,总生存率以月计算。这些情况下的管理方法主要围绕姑息化疗,尽管在某些特定病例中可考虑手术切除转移灶。

结论

以皮下转移为表现的肺癌是一种罕见的临床情况。虽然化疗仍然是治疗的基石,但在少数情况下可考虑手术干预以切除转移灶。必须进行进一步研究以确定手术对生活质量和总生存率的影响。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8fa9/10667891/9e31e33e7484/gr1.jpg

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